Mobility-impairing conditions detract from quality of life and human potential across disease category, age span, and psychosocial, economic, and cultural classifications at great costs to individuals and society. Pushrim activated power assist wheelchairs (PAPAW) combine some .of the most desirable features of conventional manual and power wheelchairs. PAPAWs resemble manual wheelchairs except that they are equipped with small, lightweight motors that deliver a brief burst of power every time the user pushes the wheel. This decreases the effort of wheeling while still allowing mobility related physical activity to take place. Like manual wheelchairs, PAPAWs are lightweight, and easy to maneuver, Like conventional power wheelchairs, PAPAWs allow users to travel further and to negotiate difficult terrains. PAPAWs show promise to decrease the pain, fatigue, and musculoskeletal costs of manual propulsion while preserving and extending the opportunity to engage in mobility-related physical activity over a wheeler's lifespan thus improving quality of life. Unfortunately, very little research has been conducted to examine whether this potential will be realized in users' everyday lives, or to define the characteristics of users associated with success or failure in using a PAP AW. The specific aims of this application are to: 1. Determine the impact of everyday use of PAPAWs on quality of life, activity, participation, pain, and affect. 2. Determine which patient characteristics are associated with greatest utilization and benefits of PAPAWs. 3. Determine users' experiences, attitudes, and beliefs regarding PAPAWs by using qualitative interview methods. Data collected in this protocol will set the stage for R01 applications to further delineate the impact of PAPAWs and other forms of wheeled mobility in users' day-to-day lives as well as to provide evidence based methodology to assist clinicians in selecting the most appropriate wheelchairs and scooters based on patients' clinical characteristics.